Cultural Awareness - 360 Degree Feedback Survey Sample #12

360 Feedback Survey

Instructions

Thank you for providing feedback for the recipient above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Rate each item using the scale shown. If you don't feel you have enough first-hand information to rate a certain item, please choose the Not Applicable option. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the comment section for that competency. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

To what extent does [Participant Name] exhibit the following ...

SELECT the rating that best reflects the employee's performance in the areas listed.

Cultural Awareness

• Values the diverse perspectives from others.
• Is curious and willing to ask questions about the cultural differences in the workplace.
• Respects others regardless of age, race, gender, nationality, or disability.
• Seeks clarification to avoid misunderstandings.
• Values the opinions of diverse groups and individual.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Problem Solving

• Ability to develop innovative solutions to problems.
• Effective in solving problems.
• Works cooperatively with others to solve problems.
• Understands the root causes of problems.
• Able to balance the needs of different people in a solution to a problem.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Technical

• Uses expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
• Seeks information from others as needed.
• Is naturally sought out by people outside his/her particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
• Keeps current with technical advances within his/her professional discipline; embraces and applies new techniques and practices
• Demonstrates mastery of the technical competencies required in his/her work.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Objectives

• Sets long-term and short-term goals.
• Communicates goals and objectives to employees.
• Assures [Company] principles are understood, employed & pursued.
• Effectively organizes resources and plans
• Establishes goals and objectives.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Trustworthy

• Demonstrates congruence between statements and actions.
• Consistently keeps commitments.
• Takes care to maintain confidential information.
• Delivers on promises made.
• Builds and maintains the trust of others.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Strengths


Areas for Development


Please give any final comments or suggestions for [Participant Name Here]'s assessment.